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waste has been disposed of into the wrong waste stream, healthcare organizations should have a system of identifying waste according to the ward or department where it is produced. This may be through the use of labelling or dedicated waste carts for particular areas. When assembling sharps bins, always complete the label on the outside of the bin, including the date and the initials of the assembler. When sharps bins are closed and disposed of, they should be dated and initialled at each stage.

Management of soiled linen in the healthcare environment

As with waste, soiled linen must be managed so as to minimize any risk to any person coming into contact with it. This is done by clearly identifying any soiled linen that may present a risk through the use of colour coding and limiting any contact with such linen through the use of water-soluble bags to contain the linen so that laundry staff do not have to handle it before it goes into the washer (NHS Executive 1995).

Linen that may present a risk may be described as foul, infected or infested. The management of all hazardous linen is similar, so the following procedure applies to any linen that is wet with blood or another high-risk body fluids (see Prevention and management of inoculation injury) or faeces, or has come from a patient in source isolation for any reason, that is where enteric, contact or droplet/airborne precautions are in place, or from a patient who is infested with lice, fleas, scabies or any other ectoparasite. Note that this procedure can be much more easily carried out by two people working together.

Procedure guideline 3.16 Safe disposal of foul, infected or infested linen

Essential equipment

Disposable gloves and apron

Water-soluble laundry bag

Red plastic or linen laundry bag in holder

Orange waste bin

Preprocedure

Action Rationale

1 Assemble all the required equipment. To avoid having to fetch anything else during the procedure and risk spreading contamination to other areas. E

2 Put on disposable gloves and apron. To minimize contamination of your hands or clothing from the soiled linen. E

3 Separate the edges of the open end of the water-soluble laundry bag. To make it easier to put the soiled linen in the bag. E

Procedure

4 Gather up the foul, infected or infested linen in such a way that any gross contamination (e.g. blood, faeces) is contained within the linen. To minimize any contamination of the surrounding area. E

5 If there are two people, one holds the water-soluble laundry bag open while the other puts the soiled linen into it. If one person, hold one edge of the open end of the water-soluble bag in one hand and place the soiled linen in the bag with the other. In either case, take care not to contaminate the outside of the bag. So as to remove the need for laundry workers to handle foul, infected or infested linen before it is washed (NHS Executive 1995, C).

6 Tie the water-soluble bag closed using the tie provided or by knotting together the edges of the open end. To keep the soiled laundry inside the bag. E

7 Place the full water-soluble bag of soiled linen into the red outer laundry bag. Do not touch this bag. To identify the linen as requiring special treatment. E

8 Remove gloves and apron and dispose of them into an orange waste bag. To avoid transferring contamination to other areas (DH 2006a, C).

9 Wash hands and forearms with soap and water. To avoid transferring contamination to other areas (WHO 2009).

10 Close the red outer laundry bag and transfer it to the designated collection area. To ensure it does not cause an obstruction and is transferred to the laundry at the earliest opportunity. E

References

Breathnach, A., Zinna, S., Riley, P. and Planche, T. (2010) Guidelines for prioritisation of single-room use: a pragmatic approach. Journal of Hospital Infection, 74 (1), 89–91.

Calandra, T. (2000) Practical guide to host defence mechanisms and the predominant infections encountered in immunocompromised patients, in Management of Infections in Immmunocompromised Patients, Part I, Chapter 1 (eds